Rotator cuff tears are a common source of shoulder pain, especially in athletes or specific occupations. The incidence of rotator cuff damage increases with age. Obesity is also associated with rotator cuff surgery. A host of conditions may be related to eventual surgical intervention including bone spurs, adhesive capsulitis, and tendon degeneration with partial or full tears. Shoulder dislocation and instability caused by trauma may also lead to surgical intervention. Standard of care includes conservative treatment with rehabilitative exercises and injections. In patients who do not respond to conservative care, surgical interventions are frequently undertaken. Although comprehensive epidemiological data is not available on the total number of procedures nationwide or worldwide, just one local Oklahoma City Clinic (HPI data) reported 751 rotator cuff surgical procedures on females between January 2004 and Dec. 31, 2008, or an average of 188 per year. The American Board of Orthopedic Surgeons reports over 25,000 members nationwide. Although the exact number of procedures is not available, it can be estimated to be in the range of 770,000 across 4100 clinics, assuming half of those Board certified specialize in shoulders, and an average practice size of three. At the low end assuming only a third of the Board members participate and assuming practice sizes of five physicians it could be estimated roughly 312,000 procedures are conducted on female patients. Regardless of method (open, mini-open, or arthroscopic) a significant period of partial disability is expected during which the patient is normally undergoing initial range of motion physical therapy. Most patients have a reduced functional range of motion for 4 to 6 months after surgery; however, this duration is patient specific and can be longer depending on factors such as the integrity of the joint prior to surgery, treatment compliance, complications and specifics of the surgical technique.
The primary muscles involved in rotator cuff disability are supraspinatus, infraspinatus, subscapularis and teres minor. These control the rotation of the arm around its long axis. Since it is advised that post surgically the shoulder should not be used with the elbow away from the side for at least 3 months after rotator cuff repair, activities of daily living are problematic on the affected side. (A less common shoulder arthroplasty or complete replacement is performed on arthritis patients (6,700 procedures in 2003 reported by Medicare). Routine tasks can become insurmountably difficult for a woman who becomes physically incapacitated.
People normally take for granted that they are able to be self-sufficient, especially in very personal matters like dressing and undressing herself. When an incapacitating event occurs, such as shoulder injury or amputation, a woman can become traumatized as the pain associated with the incapacitation is compounded by the vulnerability she faces in not being able to carry out simple tasks as before.
This difficult situation is particularly troublesome when it comes to dressing and undressing of brassieres, and is a common inquiry regarding post operative care—one which most physicians are at a loss to answer. These issues do not normally come into play when a woman selects her choice of brassiere (“bra”) undergarments. That is, typically it requires two good hands and arms and a requisite amount of physical dexterity to put a bra on and take it off. In some cases, for example, the closure is located against the woman's back requiring contorting both arms and hands to the mid-back section, or otherwise spinning the clasped bra around her torso and/or lifting the bra over her head. These types of body motions can be impossible or too painful to perform because of a physical incapacity. Also, the weight-bearing straps that typically are trained over the shoulders can be excruciating to get over an incapacitated arm, and can be invasive to the incisions and pain catheters in situations like shoulder surgery, where days or even weeks post surgery, one arm is limp, weak, lacking sufficient dexterity and strength to work straps and lift anything at all. When still under the effects of nerve block for approximately three days post surgery, assistance must be used to even lift the arm as it is numb, dead weight.
What is needed is a bra that enables a woman to carry on with her dignity in personal matters like dressing and undressing herself in the wake of such a physically incapacitating event, especially in light of her attendance at physical therapy sessions and other visits in a public setting. It is to improvements in the art directed to that need that the present embodiments are directed.